|
You are here: Home: LCU Nurses Vol 1 Issue 1 : Patient Case Summary
 |
Patient Case Summaries |
|
Mr T: A 57-year-old very fit and active nonsmoker with recurrent non-small cell lung cancer (NSCLC)
Eight years ago Mr T was diagnosed with a small lesion in the middle lobe of the right lung. He was treated with surgical resection and remained asymptomatic and without evidence of cancer until two years ago when he developed a cough and bilateral pulmonary nodules. Biopsy confirmed cancer recurrence. He was treated with carboplatin/paclitaxel with minimal response. Not wishing to take more chemotherapy, he decided to undergo treatment with the tyrosine kinase inhibitor gefitinib. After approximately six months of symptomatic improvement and stabilized disease on gefitinib, the disease progressed. The patient then enrolled in a Phase II trial evaluating the efficacy of a novel lung cancer vaccine. He recently completed treatment on that trial.
| Comment from the patient |
| “At the end of my first round of chemotherapy, the CT scan revealed a slight increase in my disease. Apparently the chemotherapy didn’t really kill off the cancer like my doctor thought it was going to, and he suggested placing a shunt and giving me more chemotherapy once a week. I didn’t want a shunt and I didn’t want any more chemotherapy. To me, sitting for chemotherapy was just wasting time. You can’t do anything. Maybe you can read a book or sleep, but that’s it and I just didn’t care for it. At the time, the only symptom I had was a cough, so I decided to get a second opinion. My primary doctor referred me to Dr Kelly. She went through all the options with me and then recommended Iressa which I took for six months and did well. I was able to remain working, playing golf and bowling and really had no side effects. It was not a problem for me at all and was much easier than taking chemotherapy.” |
| |
Mrs F: A 60-year-old flight attendant with compression of the superior vena cava secondary to small cell lung cancer
Mrs F arose one morning with a swollen face, chest and neck. A biopsy of a supraclavicular node revealed small cell lung carcinoma. She is currently being treated with cisplatin, etoposide and twice-daily radiation therapy, and the tumor is responding well.
| Comment from the patient |
“My first doctor was very impersonal. He gave me a pronouncement over the telephone that basically there was little hope for me. Even though I’ve read the statistics on this myself and I know what I’m facing, there’s a way to go about it and do it in a nice way. In contrast, my experience at the University of Colorado has been completely different. Everyone’s upbeat, and you need people to be upbeat. You don’t need people to be depressed around you. You’ve got all the depression you can deal with.
“The first three chemotherapy treatments went well. I didn’t get sick or feel tired. Now, with the radiation therapy, it’s been pretty hard. I had a really bad sore throat and my chest was sore, but that is going away. I was getting nauseated, and now I’m losing my hair. I actually worked until the radiation therapy started, because I felt well enough. When I started radiation therapy I became too tired.” |
| |
Mr L: A 59-year-old man with small cell lung cancer
Mr L quit smoking seven years ago but recently presented with progressive difficulty breathing, fatigue and loss of appetite. Chest X-ray revealed a pulmonary lesion, which on biopsy proved to be small cell lung cancer. Mr L enrolled in a Phase II clinical trial evaluating irinotecan and carboplatin, which he has tolerated very well. The tumor is responding well to this therapy. After one cycle, his pleural effusion is gone, the tumors in his lungs are smaller and his symptoms have improved. Mr L requires less oxygen, has a better appetite and is less fatigued.
| Comment from the patient |
“When I found out about the X-ray, it sort of got me down. But I got my thoughts together, went home and sat down and spoke with God. Ever since then I’ve been doing okay, because I know that God is going to take care of me. I have no problem with having cancer now. Sometimes when I think about my situation, I get a little sad, but all I have to do is read the Bible and I’m okay.
“But I am also a very emotional person and it helps me to talk about these things. I’m by myself and I don’t have anyone at home. I have friends that I talk about it with sometimes, but it makes me feel good to talk about it. I’m the type of person that if I talk about a problem, I feel a lot better than if I keep it on the inside.” |
| |
|
|
